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<br /> Code Exemptions:
<br /> A property owner,renter or lessee may purchase a permit to do an electrical installation on his/her own or qualified leased property under the
<br /> conditions as described in RCW 19.28.261.
<br /> A nonprofit corporation with current tax exempt status or a nonprofit religious organization may purchase an electrical permit as described in RCW
<br /> 19.28.091(7).
<br /> I am applying for the property owner exemption under the following conditions:
<br /> You must select the option that applies to your situation:
<br /> I swear under penalty of perjury that:
<br /> ®
<br /> I am a registered general contractor who is installing a temporary electrical service owned by me on a project where I am the general
<br /> contractor
<br /> OR
<br /> I swear under penalty of perjury that I am:
<br /> ® The owner of real property;or
<br /> ®
<br /> The renter or lessee of real property.(You must provide a signed letter from the owner of the property granting permission for you as the
<br /> tenant to perform electrical work on the property);or
<br /> ®
<br /> A nonprofit corporation that holds a current tax exempt status as provided under 26 U.S.C.Sec.501(c)(3)or a nonprofit religious
<br /> organization,and the total value of the electrical work does not exceed thirty thousand dollars($30,000.00).
<br /> AND
<br /> You must select the option that applies to your situation:
<br /> ❑
<br /> A single family residence THAT IS NOT intended for rent,sale,or lease AND I will be personally doing the electrical work AND I will occupy
<br /> the residence for at least 24 months after completion of the electrical work;
<br /> ri A NEW 2,3,or 4 unit residential property that IS intended for rent,sale,or lease AND myself and/or a regularly scheduled and paid
<br /> • employee(s)will be doing the electrical work AND I will occupy one of the units for at least 24 months after completion of the electrical work.
<br /> O An EXISTING 1,2,3,or 4 unit residential property that IS intended for rent,sale,or lease AND myself and/or a regularly scheduled and paid
<br /> employee(s)will be doing the electrical work;
<br /> 0 A farm AND I,personally,and/or a regularly scheduled and paid employee(s)will be doing the electrical work;
<br /> ® An EXISTING place of business AND I,personally,and/or a regularly scheduled and paid employee(s)will be doing the electrical work;
<br /> ®
<br /> A NEW place of business that is NOT intended for rent,sale,or lease AND I,personally,and/or a regularly scheduled and paid employee(s)
<br /> will be doing the electrical work;or
<br /> Other property that is NOT intended for rent,sale,or lease AND I,personally,and/or a regularly scheduled and paid employee(s0 will be
<br /> ® doing the electrical work.
<br /> . I am a nonprofit corporation that holds a current tax ecempt status as provided under 26 U.S.C.Sec.501(c)(3)or a nonprofit religious
<br /> organization and the total market value of the electrical work does not exceed thirty thousand dollars($30,000.00),and th electrical work'will
<br /> • be performed by appropriately certified electricians or certified and supervised trainees who are volunteering and not being compensatecFfor
<br /> electrical work per RCW 19.28.091(7).
<br /> 0 I AGREE and wish to purchase an electrical permit under the conditions described above.
<br /> Owner Name(Print)
<br /> Owner Signature Date
<br /> PERMIT# Page 3-Affidavit
<br />
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